The effects of two doses of spironolactone on serum androgens and anagen hair in hirsute women

In a study conducted 39 years ago, 30 hirsute women were divided into two groups to assess the dose-related effects of spironolactone (S) on serum androgens and anagen hair growth. Each group, consisting of 15 patients, received either 100 mg or 200 mg of S daily for 3 months. The study found that serum total testosterone decreased significantly with both doses, but unbound testosterone remained unchanged. Androstenedione levels decreased only with the 200 mg dose, while dehydroepiandrosterone sulfate levels were unaffected by either dose. Both doses similarly reduced serum dihydrotestosterone and increased 5 alpha-androstane-3 alpha-17 beta-diol, but changes in serum 3 alpha-diol glucuronide were not significant. Anagen hair shaft diameters decreased by 19% ± 8% with 100 mg and 30% ± 4% with 200 mg, both significant reductions. No correlation was found between hair growth and serum androgens, suggesting that spironolactone's antiandrogenic effects are primarily due to its peripheral action, although no clinical marker was identified to measure this effect.